Provider Demographics
NPI:1043436363
Name:BAY AREA MENTAL HEALTH SERVICES, P.A.
Entity Type:Organization
Organization Name:BAY AREA MENTAL HEALTH SERVICES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DALY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-461-0133
Mailing Address - Street 1:906 S FORT HARRISON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33756-3904
Mailing Address - Country:US
Mailing Address - Phone:727-461-0133
Mailing Address - Fax:727-461-9162
Practice Address - Street 1:906 S FORT HARRISON AVE
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33756-3904
Practice Address - Country:US
Practice Address - Phone:727-461-0133
Practice Address - Fax:727-461-9162
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME28945174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLK1165Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER
FLD03704Medicare UPIN